Urinary oxygen tension and its role in predicting acute kidney injury: A narrative review

Acute kidney injury occurs frequently in the perioperative setting. The renal medulla often endures hypoxia or hypoperfusion and is susceptible to the imbalance between oxygen supply and demand due to the nature of renal blood flow distribution and metabolic rate in the kidney. The current available evidence demonstrated that the urine oxygen pressure is proportional to the variations of renal medullary tissue oxygen pressure. Thus, urine oxygenation can be a candidate for reflecting the change of oxygen in the renal medulla. In this review, we discuss the basic physiology of acute kidney injury, as well as techniques for monitoring urine oxygen tension, confounding factors affecting the reliable measurement of urine oxygen tension, and its clinical use, highlighting its potential role in early detection and prevention of acute kidney injury.

Effects of different depth of anesthesia on perioperative inflammatory reaction and hospital outcomes in elderly patients undergoing laparoscopic radical gastrectomy

Background

To investigate the effect of different depth of anesthesia on inflammatory factors and hospital outcomes in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer, in order to select an appropriate depth of anesthesia to improve the prognosis of patients undergoing surgery and improve the quality of life of patients.

Methods

A total of 80 elderly patients aged 65 and above who underwent laparoscopic radical gastrectomy in our hospital were by convenience sampling and randomly divided into two groups : 55 groups ( group H ) and 45 groups ( group L ), 40 cases in each group. The depth of anesthesia was maintained using a closed-loop target-controlled infusion system: the EEG bispectral index was set to 55 in the H group and 45 in the L group. Venous blood samples were collected 2 h (T2), 24 h (T3) and 72 h (T4) after the start of surgery. The intraoperative dosage of propofol and remifentanil, operation duration, postoperative PACU stay time, intraoperative consciousness occurrence, postoperative hospital stay and postoperative pulmonary inflammatory events were recorded.

Results

The patient characteristic of the two groups had no statistical difference and were comparable (P > 0.05). The intraoperative dosage of propofol in group H was lower than that in group L (P < 0.05). Compared with the L group, the plasma IL-6 and IL-10 concentrations in the H group were significantly increased at T2 (P < 0.05), and the plasma IL-10 concentration was significantly increased at T4 (P < 0.05). The plasma concentrations of IL-6 and IL-10 were higher in both groups at T2, T3 and T4 than at T1, while at T4, the concentration of TNF-α in group H was higher than at T1 (P < 0.05).

Conclusion

When the BIS value of the depth of anesthesia is 45, the perioperative release of inflammatory factors in elderly patients with laparoscopic radical gastrectomy for gastric cancer is less than BIS 55, and does not affect the prognosis.

Effects of honeycomb extract on the growth performance, carcass traits, immunity, antioxidant function and intestinal microorganisms of yellow bantam broilers

Although many studies have already described the physiological effects of bee products, such as honey, propolis, pollen, and royal jelly, on livestock farming, the health benefits of the honeycomb are still not fully understood. The problem of drug residues and bacterial resistance caused by the abuse of antibiotics is becoming increasingly serious. For this reason, a safe, green substitute has to be sought. We conducted a comparative study of honeycomb extract (HE) and an antibiotic on growth performance, carcass traits, immunity, antioxidant function and intestinal microorganisms of yellow bantam broilers. A total of four hundred eighty 21-day-old female yellow bantam broilers were randomly divided into 5 groups of 6 replicates of 16 birds each. The 5 groups were as follows, with birds receiving a basal diet supplemented with 150 ppm (mg/kg) of chlortetracycline (CTE), a basal diet without HE (control group), and a basal diet with 0.1%, 0.15%, or 0.2% HE for 60 days. The results showed that HE addition significantly increased average daily feed intake (ADFI), average daily gain (ADG), decrease feed gain ratio (F/G) from 21 to 80 and 51 to 80 days of age compared to the control group, with all 3 HE addition groups having statistically identical values to the antibiotic group. HE implementation dramatically increased spleen index, serum immunoglobulin A (IgA), immunoglobulin M (IgM,), glutathione peroxide (GSH-Px), superoxide dismutase (SOD), total antioxidant capacity (T-AOC), and total cecum bacteria and Lactobacillus compared to the control group, numerically at the same level as, or even better than, the antibiotic group. HE and CTE both markly reduced serum malondialdehyde (MDA) concentration compared to the control group, with higher concentrations of HE reducing the effect more dramatically than antibiotics. Both HE and CTE significantly raised dressed yield compared to the control group. In summary, HE, as a potential antibiotic alternative, improved growth performance, carcass traits, immune function, serum antioxidant capacity and intestinal microorganisms in yellow bantam broilers. According to the cubic regression analyses, the recommended supplemental dose of HE was calculated to be 0.15 to 0.17% for female yellow bantam broilers between 21 and 80 d of age.

The Effect of Oxycodone on Post-operative Pain and Inflammatory Cytokine Release in Elderly Patients Undergoing Laparoscopic Gastrectomy

Background: To evaluate the effect of oxycodone on post-operative pain and inflammation in elderly patients undergoing laparoscopic gastrectomy. Methods: Sixty patients who were of both sexes, American Society of Anesthesiologists Physical Status (ASA-PS) Class I or II, over 65 years of age and undergoing an elective laparoscopic radical gastrectomy were randomly divided into two groups: an oxycodone group (Group O) including 20 males and 10 females and a sufentanil group (Group S) including 21 males and 9 females. The post-operative analgesia regimen was as follows: 40 mg of parecoxib sodium and 0.1 mg/kg of oxycodone was intravenously injected into Group O before the abdomen closure, while 40 mg of parecoxib sodium and 0.1 μg/kg of sufentanil was injected intravenously into Group S. Both groups were infiltrated with 20 ml of 1% ropivacaine at the end of the operation. The level of serum IL-6 and IL-10 were assayed immediately at the following timepoints: at the conclusion of surgery (T1), 1 h (T2), 6 h (T3), and 24 h (T4) after the completion of the surgery. The numerical rating scale (NRS), the Ramsay sedation score, analgesic-related adverse events, post-operative pulmonary inflammation events and the post-operative stay were recorded. Results: Compared with Group S, the serum IL-6 concentrations of Group O decreased at T₃ and T₄, while the serum IL-10 concentrations increased (P < 0.05). In Group O, the serum IL-6 concentrations at T₃ and T₄ were lower than those at T₁ (P < 0.05). The incidence of post-operative nausea and vomiting (PONV) and pulmonary inflammation in Group O was lower than that in Group S (P < 0.05). At each time point, the NRS of visceral pain in Group O was lower than that in Group S. At 6 and 24 h after extubation, the NRS of incision pain in Group O was lower than that in Group S (P < 0.05). Conclusion: Oxycodone can regulate the level of inflammatory cytokines and reduce post-operative inflammatory response.

Exciton dissociation in organic light emitting diodes at the donor-acceptor interface

Experimental in situ photoluminescence and transient photovoltage results show that the interface formed by N, N{'}-Bis(naphthalene-1-yl)-N, N{'}-bis(phenyl) benzidine (NPB) and tris(8-hydroxyquinoline) aluminum (Alq{3}) acts as an exciton dissociation site. Because of this dissociation effect, excitons formed in NPB at or within a diffusion length of the interface tend to dissociate before they radiatively decay to generate blue light. This suggests that the action of the "hole-blocking layer" used in indium tin oxide\NPB\hole-blocking layer\Alq{3}\aluminium to promote blue light emission from the NPB is more "exciton dissociation inhibition" than "hole blocking."

Disruption of insulin-like growth factor 2 imprinting in Beckwith-Wiedemann syndrome

To study insulin-like growth factor 2 (IGF2) imprinting in BWS (Beckwith-Wiedemann syndrome, an overgrowth syndrome associated with Wilms and other embryonal tumours), we examined allele-specific expression using an Apal polymorphism in the 3' untranslated region of IGF2. Four of six BWS fibroblast strains demonstrated biallelic expression, as did the tongue tissue from one of these patients. Paternal heterodisomy was excluded for all BWS patients with biallelic expression, suggesting strongly that the BWS phenotype in some patients involves disruption of IGF2 imprinting. Constitutional loss of IGF2 imprinting in a subgroup of our BWS patients, and recent reports of loss of imprinting in sporadic Wilms tumour, further strengthens the view that IGF2 overexpression plays an important role in somatic overgrowth and the development of embryonal tumours.

[A prospective study of dynamic and epidemic factor of HBV infection in the army]

In order to study the HBV infection in the army a total of 519 HBV susceptibles were observed prospectively for five years. The results showed that the cumulative infection rate of HBV was 16.12/1000 person-years and the latent infection was in the majority. There are many factors that could affect army population, the rate of HBsAg positive and the contact history with HB patients were indirect correlation with the rate of new HBV infection. Therefore it is an urgent matter to manage asymptomatic HBsAg carriers and HB patients in the army.

A natural autoantibody is encoded by germline heavy and lambda light chain variable region genes without somatic mutation

While nonmutated germline variable region (V) genes have been found to encode heavy or light chains of various human autoantibodies, the use of germline V genes by both chains of a given autoantibody has not been documented. Recently, we reported that the heavy chain V gene (designated Humha346) of the Kim4.6 anti-DNA antibody is identical to a germline VH gene, 1.9III. To investigate whether this autoantibody was entirely germline encoded, we searched for the germline counterpart to the Kim4.6 V lambda segment (designated Humla146) and isolated a V lambda I gene designated Humlv117, which was identical to Humla146. Together with the sequence identity of the Kim4.6/Humha346 and 1.9III VH genes, the current data provide the first direct proof that an autoantibody can be encoded entirely by germline V genes without any somatic change. In addition, Humlv117 is the first V lambda I germline gene that has been isolated, and is highly homologous to the V lambda genes expressed in two lymphomas. Thus, this V lambda I gene should provide a useful tool for investigating the expression of the human V lambda gene repertoire, particularly with regard to autoimmune and/or lymphoproliferative diseases.

[Analysis of 35 cases of pathology in yin deficiency syndrome]

Thirty-five cases of the pattern of Yin deficiency were studied including 18 cases of Liver and Kidney Yin deficiency, 2 cases of Lung and Kidney Yin deficiency, 15 cases of heat invasion into Ying and Blood with deficiency both in Qi and Yin. These cases displayed the following characteristics: (1) Course of the disease was insidious, protracted and prone to frequent exacerbations. (2) Clinical manifestations resulted mostly from functional impairment or metabolic derangements in vital organs/tissues, thus manifesting pleomorphism and complexity. Pathologic changes could be seen in almost all organs and tissues, being mostly marked in the liver, adrenals, testes, gastrointestinal tract, lungs and heart. The liver showed chronic active inflammatory changes or subacute necrosis. The adrenal cortex was overtly atrophic, involving all zones. Cell cytoplasm was scant and red stained with loss of lipid vesicles. The testis was also markedly atrophic. There was interstitial edema with scattering of convoluted seminiferous tubules. There was mild hyperplasia of the basement membrane. The germinal cell layer was thin and spermatogenesis decreased. Gastrointestinal mucosa was thin generally and submucosal edema was evident. Infiltrating inflammatory cells were predominantly lymphocytes. (3) These changes could be categorized as blood stasis, chronic inflammation, necrosis and atrophy that signify degeneration with impairment or loss of function. As a whole, Yin deficiency syndrome is merely a nonspecific term that covers a conglomeration of sundry chronic disease state.

Recombination between DQ alpha and DQ beta genes generates human histocompatibility leukocyte antigen class II haplotype diversity

Two major DR7 haplotypes have been defined on the basis of serologic typing: those that type as DQw2 and others that type as DQw3. In order to define the molecular basis for these serologic differences we have isolated and sequenced DQ alpha, DR beta I, and DQ beta cDNA clones from both representative haplotypes. These studies reveal that although the DQ alpha and DR beta I genes of both haplotypes are identical, the DQ beta genes are very different. These data suggest that the serologic differences of these two DR7 haplotypes are the result of a recombinational event that occurred between the DQ alpha and DQ beta genes. In addition, they emphasize the role of DQ recombination in generating "hybrid" HLA-DQ heterodimers.

Recombination between DQ alpha and DQ beta genes generates human histocompatibility leukocyte antigen class II haplotype diversity

Two major DR7 haplotypes have been defined on the basis of serologic typing: those that type as DQw2 and others that type as DQw3. In order to define the molecular basis for these serologic differences we have isolated and sequenced DQ alpha, DR beta I, and DQ beta cDNA clones from both representative haplotypes. These studies reveal that although the DQ alpha and DR beta I genes of both haplotypes are identical, the DQ beta genes are very different. These data suggest that the serologic differences of these two DR7 haplotypes are the result of a recombinational event that occurred between the DQ alpha and DQ beta genes. In addition, they emphasize the role of DQ recombination in generating "hybrid" HLA-DQ heterodimers.

Microheterogeneity of HLA-DR4 haplotypes: DNA sequence analysis of LD"KT2" and LD"TAS" haplotypes

We have isolated and sequenced cDNA clones corresponding to the polymorphic alpha and beta chains encoded by the DR and DQ subregions of two HLA-DR4 haplotypes, LD"KT2" and LD"TAS". These two haplotypes are distinguished on the basis of mixed lymphocyte culture typing. The data indicate that the designation of LD"TAS" as a distinct subtype from Dw13 is very likely due to amino acid differences in the DQ beta chain. In contrast, LD"KT2" differs from TAS and Dw13 by a single amino acid substitution at position 37 of the DR beta 1 chain. The functional and evolutionary significance of these polymorphisms is discussed.

Molecular diversity of HLA-DR4 haplotypes

Complementary DNA (cDNA) clones encoding beta chains of the DR and DQ regions and alpha chains of the DQ region were isolated and sequenced from four homozygous DR4 cell lines of different HLA-D types: GM3103(Dw4), FS(Dw10), BIN(Dw14), and KT3(Dw15). When compared with each other and with a previously published sequence from a DR4 (Dw13 cell line), the variability of DR beta 1 gene products is generally restricted to the region around amino acid position 70, with an additional polymorphism at position 86. Many of these differences, including an unusual amino acid substitution at position 57 in the Japanese cell line KT3(Dw15), may be due to gene conversion events from the DR beta 2 or DX beta genes. In contrast, DR beta 2 molecules are identical in Dw15, Dw10, and Dw4 cell lines. DQ beta chains isolated from GM3103(Dw4), FS(Dw10), and BIN40(Dw14) are also identical. However, the DQ beta sequence from cell line KT3(Dw15) differs substantially from all other previously reported DQ beta alleles, consistent with its serological designation, DQ "blank." The first domain sequences of DQ alpha chains were identical in all four cell lines. The data suggest that relatively circumscribed amino acid changes in the DR beta 1 molecule are responsible for the HLA-D typing differences between some haplotypes.

Immunosuppressive action of Qinghaosu

Qinghaosu, isolated and purified from the Chinese herb, Artemisia annua Linn, and identified as a sesquiterpene with a peroxide bridge and lactone structure, is a highly potent and non-toxic new antimalaria drug. This paper reports the immunosuppressive action of its water soluble derivative (hemisuccinate NA, QHS). The remarkable suppression by QHS of the in vitro 3HTdR incorporation by mitogen-stimulated mouse spleen cells and human peripheral lymphocytes, as well as the spontaneous incorporation by mouse thymocytes and blood cells from some leukemia patients is presented and its characteristics are described. The in vivo effect as shown by quantitative PFC is studied and the difference between the present in vitro and in vivo effects is investigated. The possible mechanism of inhibition and discrepancy in effects are discussed.